Advanced Clinical Nursing
Chapter Exam Questions
Course Introduction
Advanced Clinical Nursing is designed to deepen the clinical expertise and critical thinking skills of experienced nurses. The course emphasizes evidence-based practice, complex patient care management, and advanced assessment techniques across diverse healthcare settings. Students will engage in comprehensive case studies, interprofessional collaboration, and simulation experiences, refining their ability to make autonomous clinical judgments. Through a focus on leadership, ethical decision-making, and emerging trends in healthcare, this course prepares nurses to take on expanded roles in clinical practice, education, and healthcare system improvement.
Recommended Textbook
Medical Surgical Nursing Critical Thinking for Person Centred Care 3rd Edition by
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52 Chapters
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Page 2
Priscilla Lemone
Chapter 1: Medical-Surgical Nursing in the Twenty-First Century
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Sample Questions
Q1) A graduate nurse is attending a seminar regarding the role of the nurse as a person advocate. After the session, the students engage in a discussion. Which of the following statements by the graduate nurse indicates a need for further education?
A)'Being a person advocate entails making efforts to improve the person's outcomes.'
B)'Providing education to the person and family is a key way to be a positive person advocate.'
C)'Person advocates have the authority to make decisions for the person.'
D)'Communicating person needs to other members of the healthcare team is a role of the person advocate.'
Answer: C
Q2) The nurse is reviewing the outcome of person-centred care provided according to the plan of care. Which of the following nursing process steps would the nurse use next?
A)Assessment.
B)Planning.
C)Implementation.
D)Evaluation.
Answer: D
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3
Chapter 2: Health and Illness in Adults
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Sample Questions
Q1) A person is admitted with an alteration in liver functioning. The nurse realises this person is experiencing which cause of disease?
A)Mechanical.
B)Psychological.
C)Biologic.
D)Normative.
Answer: C
Q2) An elderly person says, 'I can't ask my daughter to do too much for me because she has to go to work.' The nurse realises this person is describing which family feature?
A)Performing family tasks.
B)Maintaining boundaries.
C)Interdependence.
D)Adapting to change.
Answer: B
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4
Chapter 3: Nursing Care of People Having Surgery
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Sample Questions
Q1) A person is being positioned for a hip replacement procedure. In which of the following positions will this person most likely be placed?
A)Lateral chest.
B)Supine.
C)Lithotomy.
D)Prone.
Answer: A
Q2) An elderly person is being prepared for orthopaedic surgery. The nurse realises this person is at risk of which of the following?
A)Decreased tolerance of general anaesthesia.
B)Increased hypotensive effects of anaesthesia.
C)Wound dehiscence.
D)Ineffective pain relief.
Answer: A
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Chapter 4: Nursing Care of People Experiencing Loss, Grief, and Death
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Sample Questions
Q1) The family of a dying person experiencing a worsening of breathing wants to help. Which of the following can the nurse instruct the family to provide for the person?
A)Encourage the person to eat.
B)Perform frequent chest physical therapy.
C)Raise the head of the bed.
D)Place the person on his left side.
Q2) A dying person tells the nurse, 'Don't let my family leave me.' What is this person demonstrating?
A)Fear of dying alone.
B)An anticipation of improvement in health.
C)Denial about his eventual death.
D)The desire to prolong life.
Q3) A preoperative person says to the nurse, 'I hope I wake up after surgery; I don't know what my family would do if I died.' This person is demonstrating which nursing diagnosis?
A)Death anxiety.
B)Chronic sorrow.
C)Coping.
D)Anticipatory grieving.
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Chapter 5: Nursing Care of People With Problems of Substance Misuse
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Sample Questions
Q1) A 76-year-old man who used to run a bar and restaurant comes into the clinic with progressive numbness and tingling of all four extremities. For which health problem should this person be evaluated?
A)Psychological dependence.
B)Co-occurring disorders.
C)Tolerance.
D)Korsakoff's psychosis.
Q2) The nurse is interviewing a person who denies having a long-standing history of alcohol and drug use. Which action should the nurse take to gain information and direct care?
A)Request an inpatient evaluation.
B)Refer to a psychologist.
C)Utilise the MAST questionnaire.
D)Confront the person.
Q3) Which manifestation may be assessed in a person experiencing opioid withdrawal?
A)Sleepiness.
B)Dilated pupils.
C)Increased appetite.
D)Joint pain.
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Chapter 6: Nursing Care of People Experiencing Disasters
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Sample Questions
Q1) The community is holding a memorial service to honour those members whose lives were lost in the flood one year ago. In which stage of the disaster recovery process is this community?
A)Restoration
B)Disaster reflection
C)Reconstitution
D)Mitigation
Q2) What does care of persons experiencing blast injuries typically focus on?
A)Psychological shock
B)Lung injuries
C)Ear and hearing trauma
D)Head injuries
Q3) Which manifestation would indicate to the nurse that the person might be in the early alarm stage response to severe shock?
A)Weak, thready pulse.
B)Dilated pupils
C)Falling blood pressure
D)Decreased temperature
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8
Chapter 7: Genetic Implications of Adult Health Nursing
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Sample Questions
Q1) The doctor has ordered chromosomal analysis for a newborn baby. Which of the following tests has been ordered?
A)Genotype.
B)Newborn screen.
C)Karyotype.
D)Phenotype.
Q2) A baby is born with a genetic disorder. Neither parent has a history of this disorder. The nurse realises that the cause of this disorder could be which of the following?
A)An autosomal dominant condition.
B)Penetrance.
C)A spontaneous new mutation.
D)An X-linked dominant condition.
Q3) A 40-year-old person tells the nurse that her mother has Alzheimer's disease (AD). The person asks if she will get this disease. What would be the nurse's best response?
A)'You do have an increased risk of inheriting this disease.'
B)'Your children are likely to inherit this disease.'
C)'You are not at any risk of developing this disease.'
D)'You have a 20% chance of developing this disease.'
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Chapter 8: Nursing Care of People in Pain
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Sample Questions
Q1) A person complaining of pain has been waiting for medication to relieve the pain. Which of the following should the nurse realise about this person? The:
A)person's pain is real.
B)person just wants medication.
C)person is demanding.
D)person wants attention.
Q2) A person is complaining of dull and aching muscle pain. The nurse realises that the transmission of this pain occurs along which nerve fibres?
A)A-delta.
B)B.
C)C.
D)D.
Q3) A person with chronic pain is being started on a 'patch.' Which of the following should be included when instructing the person about this pain-relieving delivery system?
A)Dosing will commence with a low dose.
B)It is not as effective as oral pain medications.
C)The person should never experience breakthrough pain.
D)The person should never overdose with this delivery method.
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Page 10
Chapter 9: Nursing Care of People With Altered Fluid,
Electrolyte, Acid-Based Balance
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Sample Questions
Q1) An older adult comes into the clinic complaining of watery diarrhoea for several days with abdominal and muscle cramping. The nurse realises that this person could be experiencing: which condition?
A)Hypocalcaemia
B)Hypernatraemia
C)Hypervolaemia
D)Hyponatraemia
Q2) The nurse assesses a person's recent weight loss as being 10 kilograms. How many litres of fluid did this person lose? ____________
Q3) A postoperative person is diagnosed with a fluid volume excess. Which of the following should the nurse expect to observe in this person?
A)Increased haemoglobin and haematocrit levels
B)Distended neck veins
C)Orthostatic hypotension
D)Oliguria
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11
Chapter 10: Nursing Care of People Experiencing Trauma and Shock
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Sample Questions
Q1) The nurse suspects that a person is a victim of abuse. Which of the following would give the nurse this impression?
A)Injuries that do not correlate with the person's story of the injury.
B)Caring attitude between the person and significant other.
C)Evidence of adequate fluid intake.
D)Spontaneous movement of all four extremities.
Q2) A trauma victim presents with a deviated trachea, jugular vein distension and hypotension. What is the person most likely experiencing?
A)Blunt trauma to the chest.
B)Acceleration-deceleration injury.
C)Third space fluid shifts.
D)Tension pneumothorax.
Q3) The nurse recognises that the probability of a cervical spine injury decreases if the patient has which of the following?
A)Midline cervical spine tenderness.
B)Focal neurological defects.
C)Absence of intoxication.
D)Painful distracting injury.
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Chapter 11: Nursing Care of People With Infections
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Sample Questions
Q1) The nurse is caring for a person who is requiring airborne precautions. Which of the following should the nurse wear when providing care to this person?
A)P2 respirators
B)Gown and gloves
C)Shoe covering and gown
D)Head covering and gown
Q2) An older adult with a history of lung disease had a pneumococcal vaccination 10 years ago. Which of the following should be done for this person?
A)Remind the person that he will need a booster in the future.
B)Collect a blood sample to test for antibody levels.
C)Suggest that the person have a pneumococcal booster during this visit.
D)Remind the person that he does not need a flu vaccination.
Q3) A person is having skin testing done to assess for allergies. What would be evidence of exposure to an antigen?
A)A response that only appears 5 days later
B)Itching at the site of the skin test
C)An area of approximately 1 mm of induration and erythema
D)An area of greater than 10 mm of induration and erythema
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Page 13
Chapter 12: Nursing Care of People With Altered Immunity
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Sample Questions
Q1) A person tells the nurse, 'I get stomach pains and diarrhoea every time I drink milk'. This person is a type ________ allergic response.
A)I
B)II
C)III
D)IV
Q2) An HIV-positive person comes into the clinic complaining of increasing pain in his feet and legs. The nurse realises that this person is demonstrating a(n):
A)reaction to the antiviral medications.
B)nervous system manifestation of the disease.
C)secondary peripheral vascular disease.
D)minor opportunistic infection of the lower limbs.
Q3) During the physical assessment of a person, the nurse wants to include the person's immunity function. Which of the following techniques would provide the nurse with the best information?
A)Auscultation of the heart
B)Palpation of the abdomen
C)Percussion of the lungs
D)Assessment of skin colour, temperature and moisture
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Page 14
Chapter 13: Nursing Care of People With Cancer
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Sample Questions
Q1) A person who is newly diagnosed with cancer says to the nurse, 'I don't want to spend my final days on earth in a hospital bed.' What is the nurse's best response?
A)'Why do you feel so negative about being in the hospital?'
B)'You should enjoy the life you have left'.
C)'You are not going to die from cancer'.
D)'Please tell me more about how you are feeling right now'.
Q2) A person with uterine cancer is prescribed a treatment in which radioactive material will be inserted and maintained within her vagina. Which of the following types of treatment does this describe?
A)Biotherapy
B)Chemotherapy
C)Photodynamic therapy
D)Brachytherapy
Q3) A person has breast cancer. Where is a common metastatic site for this cancer?
A)Vertebrae
B)Lungs
C)Colon
D)Spleen
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Chapter 14: A Person-Centred Approach to Assessing the
Integumentary
System
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Sample Questions
Q1) A person with hair loss (alopecia)comes into the clinic. What is this hair indicative of?
A)Cushing's syndrome
B)Changes in hormones
C)Poor nutrition
D)Vitamin D deficiency
Q2) The nurse is planning to document the appearance of herpetic lesions found over a person's nose and mouth region. Which of the following terms would the nurse most likely use to describe this finding?
A)Nodular
B)Ulcerated
C)Bullous
D)Pigmented
Q3) An adolescent male has extensive acne over his face and upper neck. What is acne caused by?
A)Blocked sudoriferous glands
B)Inflamed ceruminous glands
C)Blocked apocrine glands
D)Inflamed sebaceous glands
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Chapter 15: Nursing Care of People With Integumentary Disorders
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Sample Questions
Q1) The nurse notes pimples over the buttocks and chest of a middle-aged person. How should the nurse document this finding?
A)Keratosis.
B)Acne conglobata.
C)Acne rosacea.
D)Contact dermatitis.
Q2) A person has a fungal infection caused by Candida albicans. Which medication might have permitted this opportunistic infection?
A)Diuretics.
B)Anticonvulsants.
C)Insulin.
D)Systemic antibiotics.
Q3) A person is scheduled for an ultraviolet light therapy treatment for psoriasis. What should be included in this person's teaching?
A)The skin will appear reddened in approximately 8 hours after the treatment.
B)This is the treatment of choice for persons with psoriasis on the upper body.
C)The treatment involves gradually decreasing exposure times.
D)There is no anticipated damage to the eyes or immune system.
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Chapter 16: Nursing Care of People With Burns
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Sample Questions
Q1) A person with full-thickness burns receiving high-volume intravenous fluids has a urine output of 40 mL per hour. What is the significance of this urine volume?
A)Indicates pending renal failure.
B)Suggests overhydration.
C)Suggests dehydration.
D)Indicates adequate kidney functioning.
Q2) A person with full-thickness burns is prescribed a gastrointestinal medication. What is the primary action of this medication?
A)Promote peristalsis.
B)Prevent the onset of stress ulcers.
C)Treat a pre-existing duodenal ulcer.
D)Minimise anorexia.
Q3) A person with a major burn has dead skin and eschar. What should the nurse use to clean this wound?
A)Iodine solution.
B)Silver sulfadiazine.
C)A mild, antimicrobial soap.
D)Chlorhexidine.
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18
Chapter 17: A Person-Centred Approach to Assessing the Endocrine System
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Sample Questions
Q1) A person has elevated serum cortisol levels. Which health problem is associated with this finding?
A)Cushing's syndrome.
B)Diabetes insipidus.
C)Grave's disease.
D)Addison's disease.
Q2) A person is admitted to hospital with dehydration and excessive urination. Which hormone should the nurse suspect as causing this person's health issue?
A)Luteinising hormone (LH).
B)Antidiuretic hormone (ADH).
C)Thyroid-stimulating hormone (TSH).
D)Parathyroid hormone (PTH).
Q3) An older person has a palpable thyroid gland. What should the nurse realise this finding indicates?
A)Onset of diabetes insipidus.
B)The reason for oliguria.
C)Onset of hypertension.
D)Nothing, since this can be normal in an older person.
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Chapter 18: Nursing Care of People With Endocrine Disorders
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Sample Questions
Q1) A person with myxoedema is concerned about a rising cholesterol level despite adhering to a strict diet. How should the nurse respond to this person?
A)'It's a normal part of ageing.'
B)'The thyroid gland disease can affect your cholesterol level.'
C)'You need to cut all fat out of your diet'
D)'Maybe you don't realise how much fat is in the foods that you eat.'
Q2) A person recovering from surgical removal of the parathyroid glands has a temperature of 38.9°C with a rising systolic blood pressure. What should the nurse do for this person?
A)Administer paracetamol as prescribed.
B)Apply a cooling blanket.
C)Nothing, as these are normal postoperative findings.
D)Apply ice to the groin.
Q3) Which laboratory data would be used to diagnose a person with Grave's disease?
A)Increased serum thyroid-stimulating hormone.
B)Increased serum thyroid antibodies.
C)Decreased radioactive iodine uptake.
D)Decreased serum thyroxine.
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Chapter 19: Nursing Care of People With Diabetes Mellitus
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Sample Questions
Q1) A person with type 2 diabetes recovering from surgery is upset about having to take insulin. How should the nurse respond to this person?
A)'Didn't your doctor tell you that you would be on insulin now?'
B)'After surgery it is necessary to change over to insulin injections.'
C)'We will teach you how to give yourself the insulin injections.'
D)'It's just until you are able to take your other medication and start to recover from the surgery.'
Q2) During a visit, the nurse finds a safety hazard in the home of a person with diabetes. What did the nurse observe in this person's home?
A)Hand grips next to the toilet.
B)Throw rugs in the kitchen and bathroom.
C)Night lights.
D)Bed at the lowest level.
Q3) Which medication is classified as an ultra-short-acting insulin?
A)Protaphane.
B)Isophane NPH.
C)Insulin glargine.
D)Insulin aspart.
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Chapter 20: A Person-Centred Approach to Assessing the
Gastrointestinal
System
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Q1) An older adult tells the nurse that he is noticing that he wants more 'salt and spices' on his foods. What is this person experiencing?
A)A salt deficiency
B)Hormonal changes
C)An age-related change in taste
D)A vitamin deficiency
Q2) A person learns that he has an 'incompetent pyloric sphincter.' What could this person experience?
A)Reduced saliva production
B)Difficulty swallowing solids
C)Pain with digestion of carbohydrates
D)Inconsistent gastric emptying
Q3) A person says, 'I drink fluids throughout the day but I seem to always be hungry!' Which of the following characterises this person's gastric emptying?
A)Rapid
B)Delayed
C)Sluggish
D)Normal
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Chapter 21: Nursing Care of People With Nutritional Disorders
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Sample Questions
Q1) A female learns that she has regained 7 kg that she had lost the previous year. Which of the following would be the best response by the nurse?
A)'Even with the weight gain you are still not obese.'
B)'I can teach you about a new diet that would help you lose the weight within 2 weeks.'
C)'Weight swings like this are perfectly normal and very common.'
D)'Return to the diet, exercise, and behaviour change techniques that have worked for you in the past.'
Q2) A person is admitted for treatment of malnutrition. Which of the following assessment findings would suggest to the nurse the person is experiencing a vitamin C deficiency? Select all that apply.
A)Easy bruising
B)Depression
C)Hepatomegaly
D)Dyspnoea
E)Delayed wound healing
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Chapter 22: Nursing Care of People With Upper
Gastrointestinal Disorders
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Q1) A person who is recovering from surgery for stomach cancer a month ago continues to experience dumping syndrome. Which of the following should the nurse instruct this person to help the person address this problem? Select all that apply.
A)'It is likely to be a problem for the rest of your life.'
B)'There's no effective treatment for this complication.'
C)'Eat smaller, more frequent meals.'
D)'Only eat a clear liquid diet until the problem resolves.
E)'Drink your liquids separately from your solid foods.;
Q2) The nurse learns that a person who is being treated for peptic ulcer disease is still 'having problems'. Which of the following should the nurse instruct this person?
A)Smoking cessation techniques can help.
B)Make sure the person is keeping to their restrictive diet.
C)Avoid eating lunch.
D)Do not consume any alcohol.
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Chapter 23: Nursing Care of People With Bowel Disorders
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Q1) The nurse is assessing a person with a pancreatic disorder. The nurse realises the person might be experiencing digestive problems that affect which section of the intestines?
A)Jejunum
B)Ascending colon
C)Duodenum
D)Transverse colon
Q2) A person is undergoing a colonoscopy. Which statement reflects correct teaching by the nurse for this procedure?
A)'Make sure to include high-fibre foods in your diet as soon as possible after the test.'
B)'While it is advisable for you to have someone drive you home immediately after the exam, you may drive if you like.'
C)'It is common to experience bloating and increased flatus after this procedure.'
D)'For several days prior to the procedure, make sure that you ingest a high-fibre diet.'
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Chapter 24: Nursing Care of People With Gallbladder, Liver, and Pancreatic Disorders
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Q1) A person who is being evaluated for liver trauma that was sustained in a motor vehicle accident is found to have a negative peritoneal lavage. What is the person demonstrating?
A)Haematoma formation
B)Severe liver lacerations
C)No abdominal bleeding
D)Clotting factor malfunction
Q2) A person who is prescribed lactulose is complaining of 'diarrhoea with cramps' throughout most of the day. What is this person demonstrating?
A)An allergic response to the medication
B)The expected outcome from taking the medication
C)The need to adjust the dose of the medication
D)An anticipated side effect of the medication
Q3) A person comes into the clinic complaining of 'gaining weight only in the stomach.' This person is exhibiting signs of which condition?
A)Haemolytic jaundice
B)Hepatic encephalopathy
C)Oesophageal varices
D)Portal hypertension
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Chapter 25: A Person-Centred Approach to Assessing the Renal System
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Sample Questions
Q1) While auscultating a person's renal arteries, the nurse hears a 'whooshing' sound. What might this finding be indicative of?
A)Renal artery vasodilation
B)Acute renal failure
C)Renal artery stenosis
D)End-stage renal failure
Q2) A person is admitted with possible renal calculi. Which diagnostic test might this person undergo?
A)Laboratory urinalysis
B)24-hour urine collection
C)Renal biopsy
D)Intravenous pyelogram
Q3) During the assessment of a person's renal system, the nurse is unable to palpate the kidneys. What is this finding indicative of?
A)Normal functioning
B)Acute renal disease
C)Pyelonephritis
D)Polycystic kidney disease
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Chapter 26: Nursing Care of People With Urinary Tract Disorders
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Sample Questions
Q1) A person is discharged after treatment for a bladder papilloma. Which of the following should be included in this person's discharge instructions? Make an appointment for follow-up:
A)if symptoms return.
B)the following week.
C)in one year.
D)in three months.
Q2) A woman is admitted with multiple medical problems and incontinence, regardless of the position or situation. Which type of incontinence is the person most likely experiencing?
A)Functional.
B)Overflow.
C)Stress.
D)Urge.
Q3) A man is admitted for removal of a bladder papilloma. Which of the following should the nurse assess in this person?
A)Blood glucose level.
B)History of cigarette smoking.
C)Alcohol intake.
D)Appetite level.
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Chapter 27: Nursing Care of People With Kidney Disorders
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Q1) Which of the following should be included when providing instructions to a person who is post-nephrectomy for kidney cancer?
A)Promotion of vigorous physical activity.
B)Organ donor information.
C)Early recognition of the manifestations of a urinary tract infection (UTI).
D)The need to restrict fluid intake.
Q2) A person with chronic kidney disease is trying to decide between haemodialysis and peritoneal dialysis. Which of the following are advantages of peritoneal dialysis for this person? (Select all that apply.)
A)Lower risk of infection.
B)Better self-management.
C)Greater intake of fluids permitted.
D)Better waste product elimination.
Q3) Which of the following interventions would be appropriate for a person with excess fluid volume related to chronic glomerulonephritis?
A)Assess for manifestations of infection.
B) Schedule activities to conserve energy.
C)Document energy level.
D) Daily weights.
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Page 29
Chapter 28: A Person-Centred Approach to Assessing the Cardiovascular
and Lymphatic
Systems
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Sample Questions
Q1) What is an important nutritional-metabolic interview question to ask persons who are being evaluated for heart conditions?
A)'What heart medications are you taking?'
B)'Have you experienced chest pain in the last week?'
C)'Have you had a recent weight gain or loss?'
D)'Is there any change in your usual bowel elimination?'
Q2) The person's ECG shows the following characteristics: PR interval .08, QRS .08 and isoelectric ST segment. What do these characteristics indicate?
A)Faster than normal conduction from the SA node to the ventricles, slower than normal conduction through the ventricles and normal ST segment.
B)Normal conduction from the SA node to the ventricles, normal conduction through the ventricles and abnormal ST segment.
C)Faster than normal conduction from the SA node to the ventricles, normal conduction through the ventricles and normal ST segment.
D)Normal conduction from the SA node to the ventricles, faster conduction through the ventricles and abnormal ST segment.
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Chapter 29: Nursing Care of People With Coronary Heart Disease
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Q1) The person's ECG shows the following characteristics: PR interval .08, QRS .08 and isoelectric ST segment. What do these characteristics indicate?
A)Faster than normal conduction from the SA node to the ventricles, slower than normal conduction through the ventricles and normal ST segment.
B)Normal conduction from the SA node to the ventricles, normal conduction through the ventricles and abnormal ST segment.
C)Faster than normal conduction from the SA node to the ventricles, normal conduction through the ventricles and normal ST segment.
D)Normal conduction from the SA node to the ventricles, faster conduction through the ventricles and abnormal ST segment.
Q2) The person is being evaluated for left atrium thrombus due to a dysrhythmia (altered heart rhythm). Which of the following common cardiac tests will be ordered to assess for thrombus?
A)Blood pool imaging.
B)Cardiac catheterisation.
C)Thallium scan.
D)Transoesophageal echocardiography (TEE).
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Page 31
Chapter 30: Nursing Care of People With Cardiac Disorders
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Q1) The nurse is caring for a person who develops atrial fibrillation with a heart rate above 100 beats per minute. Place the following nursing actions in sequence from the highest priority to the lowest priority:
A) check the patency of an intermittent IV.
B) assess the person for comfort level and vital signs.
C) call the doctor to report the dysrhythmia.
D) check the person's chart for laboratory results from today's tests.
Q2) When a person's ECG shows frequent premature ventricular contractions (PVCs), the nurse expects that the doctor will create an order for which of the following? (Select all that apply.)
A)Oxygen.
B)Anginine.
C)Beta-blockers.
D)Antiarrhythmic agents.
Q3) What should a person who is taking a statin medication be monitored for?
A)Blood urea nitrogen and serum creatinine levels.
B)Constipation and sudden back pain.
C)Blood glucose and uric acid levels.
D)Serum cholesterol and liver enzymes.
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Page 32
Chapter 31: Nursing Care of People With Vascular and Lymphatic Disorders
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Q1) In the early postoperative period a person with a transplanted heart often requires low doses of which medication to support cardiac function and circulation?
A)Dopamine.
B)Enalapril.
C)Digoxin.
D)Anginine.
Q2) When caring for a chronic heart failure person with left-sided failure, the nurse would most likely hear which of the following statements from the doctor after a cardiac catheterisation?
A)'Pressures in the left ventricle and atrium are decreased.'
B)'Pressures in the left ventricle and atrium are increased.'
C)'Pressures in the right ventricle and ventricle are decreased.'
D)'Pressures in the right ventricle and atrium match the left ventricle pressures.'
Q3) What is the initial indication of valve disease?
A)It is discovered by accident on a routine chest x-ray.
B)A murmur is heard during physical exam.
C)An echocardiography study is done to preventatively check the valves.
D)It is discovered only through an ECG.
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Chapter 32: Nursing Care of People With Hematologic Disorders
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Q1) What type of anemia may be present in a patient with chronic gastritis that presents with a 'tingling' feeling in their hands?
A)Thalassaemia
B)Folic acid deficiency
C)Pernicious anemia
D)Iron deficiency
Q2) Which of the following may be the cause of oedema of the hands and feet in a patient in sickle cell crisis?
A)Poor venous return
B)Hypotonicity
C)Small vessel infarction
D)Peripheral vascular disease
Q3) A person undergoing treatment for leukaemia is scheduled for a bone marrow transplant. The nurse determines that this person is in which phase of treatment for the disorder?
A)Induction
B)Maintenance
C)Post-remission
D)Rehabilitative
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Chapter 33: A Person-Centred Approach to Assessing the
Respiratory
System
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Q1) The nurse percusses hyper-resonance over a person's lungs. What is this finding consistent with?
A)Atelectasis
B)Lobar pneumonia
C)Pleurisy
D)Chronic asthma
Q2) During an assessment, a person begins to cough. The nurse realises that this means what?
A)The person is trying to expel sputum.
B)The person has a cold.
C)Something other than air was entering the larynx.
D)The person has a respiratory infection.
Q3) Which of the following would the nasopharynx serve as a passage way for as it works in the respiratory system?
A)Air and food
B)Air only
C)Food only
D)Debris
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Chapter 34: Nursing Care of People With Upper Respiratory Disorders
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Q1) A person with multiple facial and nasal injuries needs a nasogastric tube placed. Which of the following is the appropriate method to place this tube?
A)Through the person's mouth.
B)Through the obstructed nare
C)Through the person's unobstructed nare
D)wait until the oedema in the nares subsides.
Q2) A person tells the nurse, 'After I leave here, I need to get to the dentist. My upper teeth are hurting and I don't know why.' What should the nurse do?
A)End the visit quickly so the person can get to the dentist.
B)Reschedule the appointment for another time.
C)Check the person's nasopharynx.
D)Assess the person for a sinus infection.
Q3) A middle-aged person who is diagnosed with pertussis is complaining of right-sided thoracic pain. What should the nurse assess this person for? Select all that apply.
A)Pleurisy
B)Pneumothorax
C)Pulmonary oedema
D)Rib fractures
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Chapter 35: Nursing Care of People With Ventilation Disorders
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Q1) Which of the following would be the nurse's assessment of a patient that was admitted with hypoxia that has been advanced from a face mask to a nasal cannula?
A)Improving
B)Stabilising
C)Affected by another health issue
D)Worsening
Q2) The nurse observes air bubbles in a person's chest tube water seal chamber. How should the nurse interpret this finding?
A)An emergency as air is entering the tubing
B)Normal
C)An indication that the pneumothorax is worsening
D)An indication to replace the chest tube
Q3) Which of the following should be included in the discharge instructions of a patient diagnosed with a lung abscess?
A)Complete the entire course of antibiotics.
B)Expect symptoms to initially worsen.
C)Recommence routine activities of daily living.
D)Lung abscesses rarely cause other problems once treatment is started.
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Chapter 36: Nursing Care of People With Gas Exchange Disorders
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Q1) A person diagnosed with carbon dioxide retention has a pulse oximetry reading of 80% on room air. A nurse should obtain a doctor's order to do which of the following interventions?
A)Intubate.
B)Administer low-volume oxygen and monitor respirations.
C)Provide an oral airway.
D)Commence high-volume oxygen and monitor respirations.
Q2) A person with pulmonary hypertension has an elevated haematocrit level. What should be included in the nurse's discharge instructions?
A)Instructions about anticoagulant therapy
B)Discussion of the need for long-acting corticosteroids
C)Instructions about venesection
D)Instructions about fluid restrictions
Q3) The nurse is positioning a person with atelectasis. Which of the following positions is the most beneficial for this person?
A)Semi-Fowler's
B)Lung with atelectasis lower than the lung without atelectasis
C)Lung without atelectasis lower than the lung with atelectasis
D)Supine
Page 38
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Chapter 37: A Person-Centred Approach to Assessing the
Musculoskeletal
System
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Q1) A person is seen in the doctor's office following several tests. The test results include elevated blood calcium, elevated alkaline phosphatase, elevated phosphorus, normal creatine kinase, and increased uptake of the radioisotope on bone scan. What is the most likely diagnosis?
A)Osteoarthritis.
B)Osteomyelitis.
C)Osteoporosis.
D)Bone cancer.
Q2) The person's right femur was fractured and repaired at the diaphysis. When teaching, the person asks the nurse to explain the diaphysis. What is the nurse's best response? 1)_______
A)'Short bones like the femur are cuboid, spongy bones are called the diaphysis.'
B)'Flat bones like the femur are disc-shaped and are called the diaphysis.'
C)'Irregular bones like the femur are plates of compact bone that are also called the diaphysis.'
D)'Long bones like the femur have a mid-portion or shaft that is also called the diaphysis.'
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Page 39
Chapter 38: Nursing Care of People With Musculoskeletal
Trauma
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Q1) A person has been very slow to recover from a fracture. The doctor has ordered a treatment that will increase the migration of osteoblasts and osteoclasts to the fracture site. What is the treatment?
A)Open visualisation and debridement.
B)Closed reduction and manipulation.
C)Sterile flushing of the fracture.
D)Electrical bone stimulation.
Q2) What is important when teaching a person how to use a walker?
A)How to lift the walker, advance it, then take two steps.
B)How to push down on the walker more forcefully on the affected side.
C)How to lift and carry the walker while taking steps.
D)How to use the walker to assist in standing up.
Q3) When is surgery necessary for persons with fractures? When the fractures:
A)are greenstick.
B)require direct visualisation and repair.
C)cannot be immobilised with a cast.
D)do not heal within the expected timeframe.
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Chapter 39: Nursing Care of People With Musculoskeletal Disorders
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Q1) What does the nurse planning care for a person who was diagnosed with muscular dystrophy (MD)need to remember?
A)The treatment includes daily electrical muscle stimulus.
B)The cause is related to poor blood supply to nerves and muscles.
C)The treatment of MD is aimed at eliminating the cause by identifying the specific stimuli that cause the muscle degeneration.
D)The pathophysiology of MD involves muscle degeneration, which affects activities of daily living.
Q2) A person is diagnosed with Paget's disease and is experiencing mild symptoms. What does the nurse expect will be part of the person's care plan?
A)Indomethacin (Indocin)and ibuprofen (Nurofen)to stop progression of symptoms.
B)Ibuprofen (Nurofen)and hip replacement surgery to prevent further osteoarthritis.
C)Indomethacin (Indocin)for discomfort and calcitonin (Calcimar)to prevent bone formation.
D)Ibuprofen (Nurofen)for discomfort and pamidronate to inhibit bone resorption.
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Page 41
Chapter 40: A Person-Centred Approach to Assessing the
Nervous
System
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Q1) One of the most common neurological diseases is characterised by abnormal cell firing in the brain. What does this disease cause in persons?
A)Migraines.
B)Decerebrate posturing.
C)Photophobia.
D)Seizures.
Q2) What is the appearance of normal cerebral spinal fluid (CSF)?
A)Pink without sediment.
B)Clear and colourless.
C)Yellow.
D)Amber.
Q3) When testing a person to determine if tremors are present, what should the nurse assess for?
A)Muscle spasms.
B)Rhythmic movements.
C)Diaphoresis.
D)Jerky movements.
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Chapter 41: Nursing Care of People With Intracranial Disorders
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Q1) The nurse is caring for a person with a head injury from a motor vehicle accident. What should the nurse assess for that would be a sign of increased intracranial pressure?
A)Pupils are reactive to light.
B)Bradycardia.
C)Tachycardia.
D)Change in mental status.
Q2) When assessing an adult after a fall, the nurse in the Emergency Department notes a dilated pupil on the right and a haematoma in the right temporal area. What does this most likely mean?
A)The process affecting the pupil is localised on the right side (ipsilateral pupil dilation). B)The process affecting the pupil is occurring on the opposite side and is unrelated to the right temporal hematoma.
C)The process affecting the right pupil is temporary and soon both pupils will be equal in size.
D)The process causing the right pupil to dilate is a result of brainstem injury.
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Chapter 42: Nursing Care of People With Cerebrovascular and Spinal Cord Disorders
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Q1) When caring for a person just admitted post-stroke (CVA), who has altered consciousness, the nurse should place the person in which position?
A)Flat.
B)High Fowler's.
C)Side-lying.
D)Prone.
Q2) The nurse is caring for a person with a secondary metastatic spinal cord tumour. What would be the benefit of surgery?
A)Exploration to obtain a biopsy.
B)To remove part of the tumor, to reduce spinal cord compression.
C)To eliminate the tumour with excision and drainage.
D)Complete removal of the tumour and affected spinal cord tissue.
Q3) Which of the following persons is at highest risk of a spinal cord injury?
A)23-year-old man who plays basketball.
B)20-year-old female with a history of substance abuse.
C)18-year-old male with a prior motor vehicle accident.
D)50-year-old female with osteoporosis.
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Page 44
Chapter 43: Nursing Care of People With Neurologic Disorders
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Q1) Which medication is likely to be prescribed as part of the treatment for multiple sclerosis (MS)?
A)Rivastigmine tartrate (Exelon).
B)Sodium valproate (Epilim).
C)Azathioprine (Imuran).
D)MAO inhibitors.
Q2) A person is admitted to the hospital with a suspected case of botulism. The nurse realises that the botulism infection was likely caused by which of the following scenarios? The person:
A)had a dirty wound that developed this toxin.
B)caught the disease from close contact with an infected person.
C)ate food contaminated with the toxin.
D)contracted the disease through contaminated needle sharing.
Q3) In order to care for adults with Alzheimer's disease (AD), the nurse recognises which of the following as common signs? (Select all that apply.)
A)Obsession with organisation.
B)Problems with language.
C)Inability to be comfortable in social situations.
D)Misplacing things.
Page 45
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Chapter 44: A Person-Centred Approach to Assessing the
Eye and Ear
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Q1) A person is found to need corrective lenses. Which diagnostic test was most likely used to determine this finding?
A)Retinoscopy
B)Convergence test
C)Computed tomography (CT)scan
D)Tonometry
Q2) A person sustained an injury to the inner layer of the left retina. With what will this person have difficulty?
A)Peripheral vision and colour perception
B)Bright lights
C)Night vision
D)Visual discrimination
Q3) A person is having difficulty maintaining equilibrium. Which part of the ear is involved with this symptom?
A)Ossicles
B)Oval window
C)Auricles
D)Labyrinth
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Chapter 45: Nursing Care of People With Eye and Ear Disorders
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Q1) A person with COPD is being treated for glaucoma. What medication will most likely be prescribed for this person?
A)Thiazide diuretic
B)Antibiotic
C)Beta-blocker
D)Adrenergic agonist
Q2) An older adult often responds incorrectly to questions or during general conversation. For what should this person be assessed?
A)Possible dementia
B)Level of education
C)History of strokes
D)Hearing disorder
Q3) A person with eversion of the left eyelid continues to experience eye dryness and corneal abrasions. What might this person benefit from?
A)UV protective sunglasses
B)An eye patch
C)Contact lenses
D)Corrective surgery
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Chapter 46: A Person-Centred Approach to Assessing the
Male and Female Reproductive Systems
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Q1) Upon analysis of a man's semen, it is found that the person could have difficulty making his wife pregnant. This man's semen most likely contains how many sperm per mL of semen?
A)50 million
B)100 million
C)200 million
D)300 million
Q2) An elderly man comes into the emergency department for an oedematous and painful scrotum. The scrotum transilluminates. What is this man's scrotum filled with?
A)Urinary filtrate
B)Serous fluid
C)A mass
D)Prostatic secretions
Q3) An elderly woman complains about the growth of 'hair on the chin.' What is this complaint consistent with?
A)Decreased testosterone production
B)Increased luteinising hormone production
C)Increased oestrogen production
D)Decreased oestrogen production
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Chapter 47: Nursing Care of Men With Reproductive System and
Breast Disorders
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Q1) A man is diagnosed with testicular cancer. What is the first step in the treatment of this disorder?
A)Hormone therapy
B)Aspiration of the enlarged testicle
C)Chemotherapy
D)Surgical removal of the testicle
Q2) A 65-year-old man complains of 'problems emptying his bladder, especially at night.' Of what is this man demonstrating symptoms?
A)Bladder cancer
B)Epididymitis
C)Benign prostatic hyperplasia
D)Urinary tract infection
Q3) A man with a swollen scrotum is diagnosed with fluid within the scrotal sac. For which health problem should the nurse prepare teaching for this person?
A)Hydrocele
B)Epididymitis
C)Phimosis
D)Spermatocele
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Chapter 48: Nursing Care of Women With Reproductive
System and Breast Disorders
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Q1) A 25-year-old woman is diagnosed with endometriosis. What should the nurse include when teaching the woman about this disorder?(Select all that apply.
A)If children are desired, pregnancy should occur before the disease progresses.
B)Laser ablation and birth control pills are the treatments for this condition.
C)It can be treated with minimal long-term effects.
D)The condition will improve over time.
Q2) A woman who was just diagnosed with breast cancer is scheduled for a lumpectomy. What signs should indicate to the nurse that this woman is demonstrating anticipatory grieving?
A)Making calls to her girlfriends
B)Doing a crossword puzzle
C)Laughing loudly at her roommate's jokes
D)Sitting quietly, occasionally crying
Q3) A woman is diagnosed with chocolate cysts. What should the nurse explain as being the cause of these cysts?
A)Old blood
B)Changes in melanocyte functioning
C)Hormone imbalance
D)Accumulation of pus
Page 50
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Chapter 49: Nursing Care of People With Sexually
Transmitted Infections
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Q1) A woman who was just diagnosed with a sexually transmitted disease is beginning treatment. What should the nurse remind this female to do?
A)Begin birth control pills to prevent future disease transmission.
B)Minimise sexual activity in the future.
C)Be pleased that she was not diagnosed with HIV.
D)Inform all sexual partners about the diagnosis so they can also be treated.
Q2) A woman, who missed two previous appointments, is seen for a continued infection that caused pelvic inflammatory disease. Which of the following instructions should the nurse include in the teaching session?
A)The need for meticulous personal hygiene.
B)The need to commence birth control pills while being treated.
C)The necessity of continuing with the anti-inflammatory medications.
D)The need to keep appointments and to complete all prescribed medications.
Q3) A person who was just diagnosed with syphilis is allergic to penicillin. What is the medication of choice for this person?
A)Doxycycline (Doxyhexal).
B)Erythromycin (E-Mycin).
C)Minocycline (Akamin).
D)Cephalexin.
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Chapter 50: Mental Healthcare in the Australian Context
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Q1) What are somatic delusions?
A)Beliefs that something odd is happening to a person's body
B)Beliefs that a person is being watched or followed
C)Delusions of grandeur
D)Auditory hallucinations
Q2) What does Australian legislation encompass within the concept of the meaning of mental illness? People may be deemed mentally ill if they:
A)have developmental disability of the mind.
B)engage in antisocial behaviour.
C)experience serious disturbances of mood.
D)take excessive alcohol or any other drug.
Q3) What is bipolar affective disorder?
A)Alternating between undereating and overeating
B)Recurrent episodes of extreme mood swings
C)Experiences of hallucinations, delusions and thought disorders
D)Alternating between obsessive compulsive disorder and anxiety disorder
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Chapter 51: Community Care
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Q1) Tobacco smoking would be considered which type of social determinant?
A)Distal determinant
B)Intermediate determinant
C)Proximal determinant
D)Not considered a determinant
Q2) The community nurse sees that a family member is not adhering to the person's prescribed care plan and reviews the plan with this family member. The nurse is functioning in which capacity with the family?
A)Educator
B)Provider of direct care
C)Advocate
D)Coordinator of the person's care
Q3) During the home visit, the community nurse learns the person cannot remember what they were taught about bathing and wound care. The nurse realises what about this person? The person:
A)is cognitively challenged.
B)forgot what was taught.
C)has a hearing impairment.
D)has poor vision.
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Page 53
Chapter 52: Nursing Care of Clients in Regional, Rural and Remote Areas of Australia
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Q1) Which fact is correct about remote and rural areas of Australia?
A)About half the Australian population resides outside the capital cities.
B)The greatest increase in the nursing workforce in recent years has been in rural areas.
C)There are higher rates of homelessness in rural areas compared to urban areas.
D)The number of nurses in Australia has decreased in the last 10 years.
Q2) Which of the following is an example of an open question?
A)'Does it hurt when you move your arm?'
B)'Is the pain better now?'
C)'Where is the pain?'
D)'What have you been taking for the pain?'
Q3) In the Australasian Triage Scale, what is the treatment acuity maximum waiting time for category ATS Category 1?
A)Immediate
B)10 minutes
C)30 minutes
D)90 minutes
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